Nakajima J, Furuse A, Oka T, Kohno T, Ohtsuka T
Department of Cardiothoracic Surgery, Faculty of Medicine, University of Tokyo, Japan.
Ann Thorac Surg. 1996 Jan;61(1):158-62; discussion 162-3. doi: 10.1016/0003-4975(95)00705-9.
Recently, intrapulmonary metastases in non-small cell lung cancer have been considered to have less influence on prognosis than extrapulmonary metastases. We report a subgroup found among patients with intrapulmonary metastases showing a good prognosis.
A retrospective study was performed on 236 consecutive patients with non-small cell lung cancer who underwent surgical resection of their tumors. Intrapulmonary metastases were found histopathologically in 50 of them, and their clinicopathologic features were investigated.
Analysis of postsurgical results revealed a subgroup of patients showing excellent prognosis (n = 15). They had well-differentiated adenocarcinomas with bronchioloalveolar spread and pT1-2 N0, without vascular or lymphangitic invasion. Their actuarial 5-year survival rate was 100%, with a mean survival interval to date of 28 months. However, none of the other 35 patients survived for 5 years, with a mean survival interval to date of 11 months.
We have clarified that patients with histopathologically diagnosed intrapulmonary metastases from non-small cell lung cancer do not constitute a homogeneous group. Pulmonary metastases with good prognosis, which are considered to be hematogenous metastases, may be benign lesions such as adenomatous or atypical adenomatous hyperplasias mimicking malignant tumors.
最近，非小细胞肺癌的肺内转移被认为对预后的影响小于肺外转移。我们报告了在肺内转移患者中发现的一个预后良好的亚组。
对236例接受肿瘤手术切除的连续非小细胞肺癌患者进行回顾性研究。其中50例经组织病理学检查发现有肺内转移，并对其临床病理特征进行了研究。
术后结果分析显示有一个预后极佳的患者亚组（n = 15）。他们患有高分化腺癌，呈细支气管肺泡播散，pT1-2 N0，无血管或淋巴管侵犯。他们的精算5年生存率为100%，迄今为止的平均生存间隔为28个月。然而，其他35例患者均无存活5年者，迄今为止的平均生存间隔为11个月。
我们已经阐明，经组织病理学诊断为非小细胞肺癌肺内转移的患者并非一个同质群体。预后良好的肺转移，被认为是血行转移，可能是良性病变，如腺瘤样或非典型腺瘤样增生，酷似恶性肿瘤。
